Dr Anjali Mahto is a consultant dermatologist at Skin55 and author of The Skincare Bible: Your No-Nonsense Guide To Great Skin.
Face mapping for acne is a concept that refuses to die. I know it may sound harsh but I’ve seen countless charlatans in the health sector promoting the concept as a legitimate, scientific idea for understanding your skin – and it simply isn't.
Traditional face mapping – for acne especially – originates from ancient Chinese and Ayurvedic principles. The technique claims to address the 'root cause' of spots, which, of course, appeals to many, because in this confusing world of information overload, never-ending choice and the pace of modern day living, the idea of being able to 'control' one's skin can provide solace amid the chaos.
Those who advocate facial mapping will be keen to tell you that spots in the same part of your face each month are your body’s intuitive way of telling you that there is an underlying issue with another distant organ. For example, forehead spots are simply down to problems with digestion, and cheek spots are linked to the lungs. The idea of 'wine face' and 'gluten face' may have entered your radar, too. Apparently drinking too much wine may lead to droopy eyelids and enlarged pores, to name a few symptoms, while the dreaded gluten is causing your puffy, bloated face. From a medical point of view, this anatomically and physiologically does not make sense. In fact, there is no scientific evidence to support facial mapping for acne or skin ageing.
Often, I have found that the advice comes from those who are already genetically blessed and probably have a supplement, diet plan or skincare regime to sell you. How convenient to tell people they are causing a problem through their eating choices, then selling you the solution. I have lost count of the number of young women who come to see me in clinic, having spent thousands before realising that their bank balance is going down but their skin problems are persisting. I would say that the whole concept and practice of face mapping and providing solutions is preying on the vulnerable, and potentially asking people to make dietary restrictions that are unfounded. This can lead to nutritional deficiencies and trigger disordered eating if we aren’t careful.
From a medical point of view, face mapping does not make sense. In fact, there is no scientific evidence to support face mapping for acne or skin ageing.
Taking this a step further, facial mapping has also undergone several variations on a theme as the cult of wellness grows. Some naturopaths (who are not medical doctors) have made bold claims that they can tell simply by looking at someone’s face what they are eating and how their skin is ageing. I say bold, because it is. Both acne and skin ageing are dependent on a number of factors (including environment and hormones) and blaming dietary choices singlehandedly fails to take into account the complexity of human skin in both health and disease.
So why do we get spots on our face, back and chest? Because this is where we have the highest density of oil-producing glands. The science tells us this. Certain areas where spots can occur may be related to external factors and I certainly don’t deny that. Spots on the forehead may be related to heavy waxes or sprays being applied to the hair when styling – known as 'pomade acne' – and use of heavy, oil-based foundations can lead to blocked pores, otherwise known as 'acne cosmetica'. Spots on one cheek could be related to mobile phone use, where a dirty screen surface, combined with heat and occlusion, may stimulate the oil glands. In my experience, adult women with acne often find that their spots are concentrated on the lower half of the face, neck and jawline – the so-called 'u-zone'. However, all of these circumstances are very different from the face being a reflection of what we eat or our inner health in general.
In past years, food was often used as a method of treating illnesses, but things have changed. Life expectancy has improved and science has advanced in leaps and bounds. While we don’t have the answer to everything yet, I can be certain when I say there is no role for traditional facial mapping for acne despite its celebrity support and following and the tradition of how our ancestors lived. Unlike other areas of medicine, skin health is one that branches out of the remit of doctors alone. It is much more open to promoting non-science-based treatments and this is because there is lots of money to be made from the consumer, and because the skin is a low-risk organ. If someone did something wrong with your heart or lungs it would be much more catastrophic than getting your skincare wrong. The placebo effect and our desire to believe in products adds to this milieu. This is how people can get away with giving incorrect advice and it being propagated over and over again with little accountability.
My advice? Learn to be wary of the information you find in regard to skin problems and ensure the person giving it is fully qualified to do so.